Digoxin-spezific fab fragments in the treatment of oleander toxicityin an canine model

Author(s): Selden, B., Curry, S.

Journal/Book: Annals of Emergency Medicine. 1991; 20: 1073-1077.

Abstract: Study objective: To examine the efficacy of digoxin-specific Fab fragments (dsFab) in the treatment of experimentally induced Nerium Oleander cardiac glycoside toxicity in a dog model.Design: A nonblinded, placebo-controlled experiment.Subjects: Ten adult greyhound dogs of either sex divided into treatment and control groups of five dogs each.Interventions: A tincture of Oleander was prepared and administered intravenously to each animal. After the onset of cardiotoxicity, the treatment group received 60 mg/kg dsFab IV.Measurements and main results: All dogs exhibited dysrhythmias meeting our criteria for cardiac glycoside cardiotoxicity within 27 minutes of beginning the infusion. Three of five control dogs had lethal dysrhythmias during the three-hour observation period. The remaining two control dogs exhibited dysrhythmias throughout the three-hour experiment. All five of the dsFab-treated dogs survived and converted to normal sinus rhythm within eight minutes of dsFab infusion. Three treatment animals reverted back to nonlethal and hemodynamically stable dysrhythmias after a mean of 107 minutes.Conclusion: Large doses of dsFab are efficacious in the treatment of dysrhythmias in this canine model of N oleander cardiac glycoside poisoning.[Clark RE Selden BS, Curry SC: Digoxin-specific Fab fragments in the treatment of Oleander toxicity in a canine model.

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